失效模式与效应分析在预防妇科恶性肿瘤患者静脉血栓栓塞症中的应用

目的 探讨失效模式与效应分析(failure mode and effect analysis,FMEA)在预防妇科恶性肿瘤患者围手术期静脉血栓栓塞(venous thromboembolism,VTE)中的应用效果。方法 选取2020年1月至2022年1月温州医科大学附属第一医院收治的200例妇科恶性肿瘤患者为研究对象,将2020年1月至12月收治的100例患者纳入对照组,采用常规模式进行VTE预防管理,2021年1月至2022年1月收治的100例患者纳入观察组,实施基于FMEA模式的VTE预防管理流程,找出潜在的失效模式,分析失效原因,提出改进措施并落实。比较两组患者的VTE预防管理效果。结果 实施FMEA管理后,观察组患者的VTE发生率显著低于对照组(6%vs.14%,χ²=4.310,P=0.038);观察组患者的D-二聚体水平显著低于对照组(P<0.05),术后左右股静脉血流速度均显著高于对照组(P<0.05);观察组患者对护理的总满意率显著高于对照组(98%vs.91%,χ²=4.714,P=0.030)。结论 FME...

Application of failure mode and effect analysis in the prevention of venous thromboembolism in patients with gynecological malignant tumors

Objective To explore the application effect of failure mode and effect analysis (FMEA) in the prevention of perioperative venous thromboembolism (VTE) in patients with gynecological malignant tumors. Methods From January 2020 to January 2022, 200 patients with gynecological malignant tumor admitted to the First Affiliated Hospital of Wenzhou Medical University were selected as the study objects. A total of 100 patients admitted from January to December 2020 were included in control group and VTE prevention management was performed in the conventional mode. A total of 100 patients admitted from January 2021 to January 2022 were included in observation group, and the VTE prevention management process based on FMEA mode was implemented to identify potential failure modes, analyze failure causes, propose improvement measures and implement them. The effect of VTE prevention and management was compared between the two groups. Results After FMEA management, the incidence of VTE in observation group was significantly lower than that in control group (6% vs. 14%, 2=4.310, P=0.038). The level of D-dimer in observation group was significantly lower than that in control group (P<0.05), and the postoperative blood flow velocity of left and right femoral veins were significantly higher than those in control group (P<0.05). The total satisfaction rate of observation group was significantly higher than that of control group (98% vs. 91%, 2=4.714, P=0.030). Conclusion FMEA can reduce the incidence of postoperative VTE in patients with gynecological malignant tumor, improve the quality of clinical care and patient satisfaction, and can be used in clinical application.